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Johns Hopkins Health - Care and Feeding

Winter 2010
Issue No. 7

Care and Feeding

Date: January 24, 2010

blue and white checked baby bib

Infants routinely spit up as part of their daily feedings. But when spitting up seems excessive, or your baby is fussy with feedings, arching the back, and coughing or choking while feeding, acid reflux may be the problem.

For most infants, reflux is due to a poorly coordinated gastrointestinal tract. “Reflux typically starts in the first month of life and gets worse between then and 4 months of age,” says pediatric gastroenterologist Karla Au Yeung, M.D. The standard guide for parents is that 98 percent of kids will get better by 18 months of age.

To help, if your baby has reflux symptoms, make positioning changes before and after feeding. Following a feeding, it may also help you to recline and hold your baby chest-to-chest.

“The longer, the better,” Yeung says. “That way the stomach has time to empty.”

Also, feeding while your baby is sitting in a swing or car seat is probably not a good idea. Yeung says that it causes increased pressure on the belly because of the way the hips are flexed.

For more information about pediatric gastrointestinal problems, visit For appointments and consultations, call 877-546-1872.